Last Tries to Increase Supply, 3 Months Out

I posted some time back in the newborn forum, we've made progress in some aspects but milk supply is still an issue. Baby was having difficulty latching and sleepiness in the first 2 days, he was becoming dehydrated and needed formula supplementation. I came home with a double electric pump and was nursing and pumping with the supplement at every feeding. At day 5, they found a tongue tie (a very obvious one had we known what to look for) and clipped at the pediatrician. His latching and eating didn't really start improving until week 6 or so. I took a break from nursing but continued to pump after the first few weeks because the frustration level wasn't good for either of us. I stuck with mainly pumping and a few nursing sessions for the first 2 months. I never had any sudden increase in milk, I've always been able to supply half or less. I have hypothyroidism that was monitored and within normal levels throughout my pregnancy. We also checked the TSH after he was born (somewhere around 8 weeks maybe?) and it was in the normal range. I didn't have significant breast changes in pregnancy other than nipple tenderness and very painful vasospasms with cold.

I saw several IBCLCs in the first three weeks to work on positioning and potential ways to increase supply. They recommended a hospital grade pump, nursing as much as possible and Motherlove More Milk Plus. I did eventually get the rental pump but didn't notice any difference in production. I switched to nursing instead of pumping about a month ago, production went up an additional 2oz or so a day.

I made another appointment with the IBCLC to discuss options for increasing my supply, said at this point it's going to be pretty tough to make much improvement but if I can pump it would help. She also suggested Goat's Rue and More Milk (apparently Fenugreek is contraindicated with hypothyroidism).

He eats 6-8 times a day, usually 7. He eats every 2-2.5 hours during the day and sleeps through the night. The first feeding after his long sleep, I can nurse without supplement and he gets from 4-5oz (we're renting a BabyWeigh scale). The next feeding he usually gets around 2oz from me, the rest of the day he gets 1.2-1.4oz very consistently. After tracking the past couple weeks every feeding with the scale, he's getting about 13oz nursing and 14-15oz of formula.

So, I'm at the point now where I'm almost ready to accept that this is my upper limit in milk production but I'm willing to try one more round to increase my supply. I am starting to add a 10 minute pump after nursing and supplementing today to see if it's doable. So far, it's been okay. I'm also considering trying the herbal supplements suggested by the LC.

Any thoughts on what I can realistically expect at this point? Or ideas on what would help? The one thing I am reluctant to do is pump in the middle of the night during the long sleep period, but if it would potentially make a big difference I will have to consider it.

I've looked back through our logs of feedings (we've recorded every feeding and diaper since he was born 3m1wk ago) to try to figure out what we did "wrong" but I'm not seeing it. Maybe more pumping with a rental in the first couple of weeks? I'm not sure. I know it doesn't matter at this point, but next time around hopefully we can be better prepared for potential difficulty.

Re: Last Tries to Increase Supply, 3 Months Out

What if you offer to nurse overnight? I do think the long stretch with no milk removal could be holding your production back. Waking up to pump is no fun, but most babies will happily nurse in their sleep! Especially since you are only averaging 7 feeds a day. Most babies that age have more nursing sessions, and most babies that age aren't STTN. So that's where I would start.

Your baby is taking pretty close to reasonable amounts of milk during a nursing session. I think you'd get closer if you just had more sessions. Can you offer more frequently during the day, too? My daughter never went 2 hours without nursing at that age...at 12 months, we rarely go that long! I do believe I have a low maximum storage capacity, so frequent feeds are what we need for me to make enough. It might help you, too. More milk removal tells your body to make more milk.

Apologies for the short responses! I'm usually responding one-handed on my smartphone!

Re: Last Tries to Increase Supply, 3 Months Out

Thank you for the reply, sorry it took so long for me to respond, schedule is a little crazy at the moment. I'm on day 4 of the pumping after every feeding, so far have not seen any increase in overall milk production (overall getting 14-18 nursing or pumping instances). He has been eating 8 times a day the past few days, but still going about 7 hours between feedings overnight. I'm a little reluctant to do an overnight feeding with him because I already have issues with him falling asleep while eating, he'll continue to eat while he's latched on but getting him to latch when he's sleepy like that can be a real chore. I also kind of worry that if he's woken up completely, he'll want a full meal (with supplementation). But the only way to find out is to try. If I can drag myself out of bed in the middle of the night. I surely don't want to set an alarm for 3am :P

I'm not sure how to go about offering more frequently during the day. If he isn't very hungry, he just plays around (which is terribly cute) smiling and moving to latch then popping off and grinning at me before doing it again. But then once he is hungry, it's been a fight just to get him down to 3.5-4oz per meal. If he gets less, he's just not a happy camper. He won't be smiling and super crabby until he eats again.

Re: Last Tries to Increase Supply, 3 Months Out

It sounds like you are offering frequently during the day, which is great. I agree with sonogirl though. 7 hours is a REALLY long stretch of sleep for a 3 month old. I think getting in another nursing or pumping session in the middle of that stretch could definitely help your supply - maybe more than doing so much pumping during the day, which is exhausting and can result in diminishing returns. I understand your reluctance to wake a sleeping baby (and yourself) - but there is no guarantee that baby will continue to sleep this long stretch, and if he does start waking up at night, it's nice if you can bring your supply up to the point where you can nurse him back to sleep without having to get up to prepare a bottle! Anyway, I don't think that's a decision we can make for you, but to me it does jump out as the most obvious way to try to increase supply.

Re: Last Tries to Increase Supply, 3 Months Out

Thank you. I wish he would just wake up for an overnight feeding. He used to, but now he only does once or twice a week at most. I do want to try everything before "giving up" on increasing my supply. Maybe I can try the trick of having a bunch of water before bed so it'll be less jarring then an alarm to get up. As far as pumping during the day, what do you think would be most helpful?

Re: Last Tries to Increase Supply, 3 Months Out

I have twins who are 4 mos old, 3 mos adjusted so your baby's age. I wouldn't let them sleep that long. I set mt alarm for midnight and 3:30 a.m. although they also wake up around then any way. I also struggle with supply and will tell you with my singleton I never went more than 3 hrs without removing milk and that meant setting an alarm and pumping in the night twice/night. Decide if it's worth it to you but if he won't nurse even if you try to wake him (my husband changes our babies diapers and then I nurse and that usually wakes them up) I would pump. More than 3-4 hrs without milk removal will in time cause supply to drop.

Is baby emptying your breasts pretty thoroughly or how much do you get pumping after he nurses? I finally stopped pumping after nursing because I was getting so little and my supply did not drop. I also rented a baby medela scale so I knew what I made every day. After 4 weeks of that my supply was still stable to I decided not to pump any more and it was very freeing although I still nurse a ton! (about 10-12 times a day for two babies).

Re: Last Tries to Increase Supply, 3 Months Out

After thinking about it, I do think I'd rather let him sleep as he naps little during the day. I get him down for a nap every 2 hours, but he only sleeps for about 30 minutes before he's up and ready to play or eat. Sometimes he gets another 2 or so hours after his first feeding after the night, sometimes not. We're kind of at the lower limit for the amount of sleep he should be getting as it is. I will try the overnight pumping.

As far as pumping after he nurses, he's really improved on that front. The most I get is 10mL (unless it's after the morning feeding), often it's only 3 or 4mL. I do only pump for 10-15 minutes, maybe I could eke out a few more mL after 20 minutes but that doesn't seem worth the wear and tear and time.

Re: Last Tries to Increase Supply, 3 Months Out

Originally Posted by @llli*rviolet

We're kind of at the lower limit for the amount of sleep he should be getting as it is.

Just want to remind you--there are really no "shoulds" when it comes to the amount of sleep your baby is getting. There's nothing wrong with frequent 30 minute naps. At that age, my daughter was taking about five or six 20 minute naps a day. Even now, at 12 months, she is just not a long napper. The idea that babies have to be taking these hours-long naps, I think, comes about mostly from parental convenience. Sure, some babies do it. But many, many babies don't, and there's nothing wrong with that, and nothing you need to fix or compensate for!

It is, of course, still up to you whether or not you want to wake baby to try and get in another feed. I just don't want you to throw out the possibility of doing do simply based on the idea that baby isn't getting enough sleep because he's a short napper.

Apologies for the short responses! I'm usually responding one-handed on my smartphone!

Re: Last Tries to Increase Supply, 3 Months Out

I used to get up to pump during the one or two months my LO slept through the night. I didn't want to wake her and she wasn't the type who could be roused enough for a dream feed. It was awake for hours or nothing at that time. It was kind of a pain, but you're really only up maybe 20 minutes to a half hour. A few times LO would wake up as I was pumping, but DH would just come get me and I would nurse her then.

Mom to my sweet little "Pooper," born 10/12/11, and "Baby Brother," born 6/23/2014, and married to heavy metal husband. Working more than full-time, making healthy vegetarian meals for family, and trying to keep up with exercise routine.

Re: Last Tries to Increase Supply, 3 Months Out

Yeah, I know what you're saying! But I do want to make sure he gets at least 10-11 hours a day. When he's behind, he tends to conk out cold while trying to eat which makes the rest of the day's feedings/naps all out of whack and he's overall a little cranky. Understandably so!